Balancing Principles in Beauchamp and Childress
ABSTRACT: In the latest edition of Principles of Biomedical Ethics, Tom Beauchamp and James Childress provide an expanded discussion of the ethical theory underlying their treatment of issues in medical ethics. Balancing judgements remain central to their method, as does the contention that such judgements are more than intuitive. This theory is developed precisely in response to the common skepticism directed at "principlism" in medical ethics. Such skepticism includes the claim that moral reasoning comes to a dead halt when confronted by competing conflicts between moral norms in a given pluralistic situation. In this paper, I use examples from the text to show that despite the authors’s arguments to the contrary, balancing judgements are the product of unreasoned intuitions. Given the necessity of some such judgements in any principle-based system, my argument highlights the degree to which principled ethical reasoning rests upon an arational core.
"Principlism" is the term often used, sometimes derisively, to refer to a method of moral reasoning found in medical ethics and elsewhere. At the core of principlism is the idea that ethical justification rests primarily, if not exclusively, in appeals to more general or "higher level" moral norms under which any more particular ethical claim can be subsumed.
Principles of Biomedical Ethics, by Tom Beauchamp and James F. Childress, has for many critics in medical ethics exemplified the worse sins of "principlism." From its first edition, the authors have argued for the importance and usefulness of general principles for justifying ethical judgments about policies and cases in medical ethics. The organization of their book reflects this conviction, dividing discussion of particular ethical problems under the rubrics of the key ethical principles which the authors believe should govern our moral judgments: principles of autonomy, nonmaleficence, beneficence and justice.
It was always a caricature of their views to label them as straight-arrow deductivists. (1) At the very least, they have from the first insisted on the necessity of making judgments about the proper balance to be struck between competing ethical commitments when they are in conflict. Since Beauchamp and Childress disavow appeal to any overarching framework from which such a balancing judgment could be derived, particular moral judgments could never for them be simple deductions from any single moral principle.
But then one may ask how Beauchamp and Childress handle one of the key criticisms of principlism, which points to the inevitable conflict among principles in the sort of pluralistic system favored by many, (2) and the resulting need to "balance" or prioritize the norms in conflict.
Harris, Trudier. "The Trickster in African American Literature." Freedom's Story Teacher Serve (n.d.). 05 03 2014. <>.
In the realm of medical ethics, there are many topics that are debated and discussed, but there is not necessarily one clear, correct answer. One of these topics is paternalism. Many questions are bandied back and forth: is it beneficial, should it be disallowed entirely, are there instances when paternalism is good and beneficial, and the list goes on. For each of these questions there have been authors who have provided their comments. One such author is Alan Goldman. He draws a very firm line on paternalism, simply put: medical paternalism is deleterious to a patient because it intrudes on their primary rights of liberty and autonomy. This paper is going to expound upon Goldman’s viewpoint in detail, going through point by point how he presents his argument. There will then be a critique of Goldman’s viewpoint that will counter his main points. The counterpoints will show Goldman’s views on paternalism are incorrect and should not be considered valid.
Gedge, E., & Waluchow, W. (2012). Readings in health care ethics (2nd ed.). Toronto, Ontario: Broadview Press.
“Those Winter Sundays” by Robert Hayden, “My Father as a Guitar” by Martin Espada, and “Digging” by Seamus Heaney are three poems that look into the past of the authors and dig up memories of the authors fathers. The poems contain similar conflicts, settings, and themes that are essential in helping the reader understand the heartfelt feelings the authors have for their fathers. With the authors of the three poems all living the gust of their life in the 1900’s, their biographical will be similar and easier to connect with each other.
One of the most prevalent and pervasive social issues in the United States today is the provision of equal access to health care for the impoverished. Far too many people live in conditions of poverty and struggle to find the means by which to meet their basic needs. For those without insurance, access to medical care is often preempted by other necessities. An unexpected medical expense can push this group further into poverty. Those who do have insurance may find themselves underinsured in the event of an emergency and unable to make the necessary co-payments. Alternatively, the insured’s provider may refuse to cover certain conditions. Besides the cost of adequate insurance and the booming cost of medical care, there are other factors that affect equal access to medical care for the impoverished. Among these are race, age, and geographic location. Poverty and the resulting inadequate medical care is a ubiquitous social problem that merits further discussion of the issue’s causes and implications.
The constitution of the World Health Organization states that “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition” (Koh and Nowinski 2010 pp 949). One would hope that this sentiment would also include the low income women of our society, however it has become a harsh reality amongst poverty stricken women that fair and affordable health care is difficult to provide for themselves and for their families. Women with an income below the federal poverty level are at a higher risk of being uninsured or under insured than the general population (Legerski, 2012). The inability to acquire adequate health insurance both privately offered and state funded, in particular can be a serious barrier to low income women's ability to seek health care (Magge, 2013). Furthermore poverty can cause some women to engage in dangerous “street involvement” causing health care providers to act with unjust prejudice in regard to their health care (Bungay, 2013). This paper will attempt to further address and justify these broad statements regarding low income women and their relationship to health care. It makes the argument that if we must see the highest attainable standard of health care as a fundamental human right than by not safeguarding our society’s impoverished women from these trials and tribulations are we not, as a country making a concession that low income women are less worthy or these rights?
Jecker, N. (1990). Integrating medical ethics with normative theory: Patient advocacy and social responsibility. 11(2), 125-139.
"Burn, burn, burn," says Kerouac, and that is what the Beats were all about. From the all-night, smoke-filled jazz clubs of the Lower East Side of Manhattan, to the trendy bars of San Francisco, the artists known as the ‘Beats’ were interested in one thing, and only one thing: living. To them, life was a series of adventures to be lived. Going from one high to the next, in search of that thing that will, in the end, transform them into that "blue centerlight" about which everyone says "Awww!" But a few questions must be addressed regarding the Beats. Was theirs the correct choice? Was the fun they had worth the pain that they caused, and the pain that they had to endure? And ultimately, what impact did the Beats have on society as a whole, and was that impact, is that impact, positive or negative? Jack Kerouac, the most prominent of all Beat poets, and the gang hanging out at the famous 115th Street apartment helped to mold two generations of young Americans, and have made a permanent impression on the landscape of American culture through their literature, and most of all, through their lives, and their desire to live. This is the contribution of the Beats: a legacy of s...
Deontological moral theory is a Non-Consequentialist moral theory. While consequentialists believe the ends always justify the means, deontologists assert that the rightness of an action is not simply dependent on maximizing the good, if that action goes against what is considered moral. It is the inherent nature of the act alone that determines its ethical standing. For example, imagine a situation where there are four critical condition patients in a hospital who each need a different organ in order to survive. Then, a healthy man comes to the doctor’s office for a routine check-up. According to consequentialism, not deontology, the doctor should and must sacrifice that one man in order to save for others. Thus, maximizing the good. However, deontological thought contests this way of thinking by contending that it is immoral to kill the innocent despite the fact one would be maximizing the good. Deontologists create concrete distinctions between what is moral right and wrong and use their morals as a guide when making choices. Deontologists generate restrictions against maximizing the good when it interferes with moral standards. Also, since deontologists place a high value on the individual, in some instances it is permissible not to maximize the good when it is detrimental to yourself. For example, one does not need to impoverish oneself to the point of worthlessness simply to satisfy one’s moral obligations. Deontology can be looked at as a generally flexible moral theory that allows for self-interpretation but like all others theories studied thus far, there are arguments one can make against its reasoning.
Niewczyk, Paulette M., and Jamson S. Lwebuga-Mukasa. "Is Poverty the Main Factor Contributing to Health Care Disparities? An Investigation of Individual Level Factors Contributing to Health Care Disparities."WWW.JEHONLINE.COM. THE JOURNAL OF EQUITY IN HEALTH, Oct. 2008. Web. 7 May 2014.
Garrett, T. M., Baillie, H. W., & Garrett, R. M. (2010). Health care ethics: Principles and problems (5thed.). Upper Saddle River, NJ: Prentice Hall.
One theme that is prevalent throughout much of the literature we have covered so far is that it is very critical of the conformist values of late 1950s society. In an era of Levittowns and supermarkets and the omnipresent television, there was a call to leave the conformist suburban culture in search of something higher. Two major proponents of the individual as opposed to society were Jack Kerouac and Allen Ginsberg, two of the central figures in the Beat movement. Through their work one can gain a perspective on the anti-conformity spirit that was brewing under the surface in the Beat culture.
McGee, Glenn and Arthur L. Caplan. "Medical Ethics." Microsoft® Encarta® 98 Encyclopedia. © 1993-1997: Microsoft Corporation. CD-ROM.
The beat generation is known as a post war generation due to its close proximity to the end of WWII. Many members of the post war generations suffer from the lack of a fixed identity, questioning who they are, what they want out of life, and what are their limits. M...
The label “Beat Generation” was first publicized in a 1952 New York Times Magazine article entitled, “This is the Beat Generation.” In this article, author John Clellen Holmes states that “beat” means “More than mere weariness,” involving “a sort of nakedness of mind, and, ultimately, of soul; a feeling of being reduced to the bedrock of consciousness.” (Holmes) These feelings became the inspiration for the Beat writers and from them sprang ideas that permeated throughout society. Major interests among the Beats were freedom, self-expression, and a rejection of mainstream ideologies (such as those governing drugs, sex, and spirituality). (Scheibach 213)